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Related Experiment Video

Updated: Jun 28, 2026

Lesion Explorer: A Video-guided, Standardized Protocol for Accurate and Reliable MRI-derived Volumetrics in Alzheimer's Disease and Normal Elderly
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'On-track' and 'off-track' shoulder lesions.

E Itoi1

  • 1E. Itoi, Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.

EFORT Open Reviews
|September 22, 2017
PubMed
Summary
This summary is machine-generated.

Shoulder stability is maintained by various structures and depends on arm position. The "on-track/off-track" concept using the glenoid track reliably predicts the risk of Hill-Sachs lesions causing shoulder dislocation.

Keywords:
Hill-Sachs lesionglenoid bone lossglenoid trackoff-track lesionon-track lesionshoulder instability

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Area of Science:

  • Orthopedics
  • Biomechanics
  • Sports Medicine

Background:

  • Shoulder stability relies on capsulo-ligamentous structures, intra-articular pressure, and concavity-compression effects, varying with arm position.
  • Glenoid bone loss and Hill-Sachs lesions (HSL) are common in anterior shoulder instability, often occurring together as bipolar lesions.
  • The glenoid track describes the contact zone between the glenoid and humeral head during arm movement.

Purpose of the Study:

  • To explain the biomechanical factors influencing shoulder stability.
  • To define and differentiate types of glenoid bone loss and Hill-Sachs lesions.
  • To introduce and validate the clinical utility of the "on-track/off-track" concept for predicting HSL engagement and recurrence.

Main Methods:

  • Review of biomechanical principles of shoulder stabilization.
  • Classification of bone lesions in shoulder instability.
  • Clinical validation of the glenoid track and "on-track/off-track" classification for predicting lesion engagement.

Main Results:

  • The "on-track/off-track" concept accurately predicts the engagement risk of Hill-Sachs lesions with the glenoid.
  • "Off-track" lesions pose a significant risk for recurrent dislocations.
  • Treatment decisions for "off-track" lesions depend on glenoid defect size and recurrence risk, often involving remplissage or Latarjet procedures.

Conclusions:

  • The glenoid track and "on-track/off-track" classification are crucial for understanding and managing shoulder instability.
  • Accurate assessment of HSL and glenoid bone loss is essential for surgical planning.
  • Remplissage or Latarjet procedures are indicated for "off-track" lesions to prevent recurrence.